Mastectomy

Many cancers can be treated with breast conserving surgery. There are some situations however, where a complete mastectomy is the most suitable form of treatment.

A modified radical mastectomy is the standard operation in these situations. All of the breast tissue, overlying skin and the nipple are removed to leave a thin transverse scaracross the chest. The chest-wall muscles are preserved.

Reasons for mastectomy include:

• Large tumour
• Multiple tumours
• Patient unwilling or unable to have radiotherapy after surgery
• Cancer recurrence following breast-conserving surgery
• Patient preference

Patients who have a mastectomy do not usually require radiotherapy to the chest wall unless the margin of excision is inadequate or there are multiple axillary nodes affected by the cancer.

After mastectomy you will be provided with a soft temporary prosthesis to wear inside your bra. Once the wound is healed you will be fitted with a permanent external prosthesis that is measured to match your other breast in size and weight. Some women with a large breast size elect to have a reduction procedure on the healthy breast. This reduces the asymmetry and helps with dressing and balance.

What to expect after surgery:

Both partial and full mastectomy operations are performed under a general anaesthetic and require about two to two and a half hours in theatre. A plastic suction drain will be inserted to drain any fluid that may build-up in the first few days after surgery. The drain is usually removed after 2-3 days, before you leave hospital. The incisions are closed with dissolving sutures positioned under the skin and this means that no stitches need to be removed. You will spend 2-3 nights in hospital and by the time you are discharged you should be quite mobile and able to manage all routine activities. Pain is usually easily controlled with Panadol or other simple pain tablets. There will be a waterproof, plastic dressing covering the wound and you can bath and shower as normal.

Possible complications after mastectomy

Bruising - is common and will settle in a couple of weeks.

Bleeding - occasionally there may be extensive bleeding into the tissues that can cause painful swelling. This is called a haematoma and you may need to go back to theatre so that the bleeding can be controlled properly.

Wound infection - causes the wound to become tender, warm and swollen. There may be redness and discharge of pus from the wound. You may feel feverish. Antibiotics will be required.

Seroma - A collection of fluid may form at the site of surgery. This can be easily drained in the clinic with a needle and syringe. Fluid build-up usually stops within 3- 4 weeks.

Decreased sensation - There may be areas of numbness in the skin of the breast and also along the inside of your arm.

Balance and posture - After mastectomy some women may notice a change in posture due to loss of the breast. Wearing a breast prosthesis will help.

Local recurrence - even after a full mastectomy there is a 5-10% chance that the cancer could recur either on the chest wall or in the scar.

Emotional and psychological effects - the diagnosis and treatment of breast cancer can have significant effects on a womens' self-esteem, body image and relationships. Please discuss any concerns or difficulties in this area. Support and professional counselling are available.

Breast Prosthesis Subsidy There is a government subsidy available for purchasing a suitable prosthesis.

Read more about terms and conditions  of HFA subsidy at  Breast Prosthesis Subsidy

A request form can be completed after your surgery.

There are a number of specialist shops that provide advice and assistance with selecting a prosthesis

Anita Breast Care Centre 1st Floor Lingerie World, Silverdale  Ph 09 4275283    or  0800 264822

Naturalwear Surgical fitting service 120 Symonds street, Royal Oak, Auckland   Ph 09 6243718

Amoena prosthetic range